Vladislav I Gorengaut, MD
Individual provider Active NPI Diagnostic Radiology Physician · La Grange, IL
NPI 1194772590 · NPPES record last updated Aug 4, 2021
Key facts
- NPI
- 1194772590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 036113511 (IL)
- Practice address
- 5101 Willow Springs Rd
La Grange, IL 60525-2600 - Phone
- (708) 245-9000
- NPI assigned
- May 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Suburban Radiologists, S.C.
Practice addresses (Care Compare)
120 N Oak St
Hinsdale, IL 60521-3829
Phone (630) 856-9000
5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (708) 245-9000
701 Winthrop Ave
Glendale Heights, IL 60139-1405
Phone (630) 545-8000
Hospital & facility affiliations
- Uchicago Medicine Adventhealth la Grange
- Uchicago Medicine Adventhealth Hinsdale
- Uchicago Medicine Adventhealth Glenoaks
- Uchicago Medicine Adventhealth Bolingbrook
- Loyola University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050809000797 | IL | Practitioner - Diagnostic Radiology | 1658332630 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036113511 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suburban Radiologists, S.C. | Diagnostic Radiology | Current |
Accepting new patients |
| Clinical Radiologists, S.C. | Diagnostic Radiology | Past | Accepting new patients |
Locations
500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000
630 E North Ave
Carol Stream, IL 60188
Phone (630) 458-5300
1446 Momentum Pl
Chicago, IL 60689
6084 S Archer Ave
Ste 102
Chicago, IL 60638
Phone (773) 767-2461
701 Winthrop Ave
Glendale Hts, IL 60139
Phone (630) 312-2000
908 N Elm St
Hinsdale, IL 60521
Phone (630) 325-3310
1 Salt Creek Ln
Hinsdale, IL 60521
Phone (630) 286-5500
5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073
120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700
15720 S Route 59
Plainfield, IL 60544
Phone (630) 312-3301
2434 Wolf Rd
Westchester, IL 60154
Phone (630) 856-6800
6311 S Cass Ave
Westmont, IL 60559
Phone (630) 323-5214
545 Plainfield Rd
Willowbrook, IL 60527
Phone (630) 269-2886
2363 63rd St
Woodridge, IL 60517
Phone 22477355880000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036113511 | IL | Yes |
Addresses
Primary practice location
5101 Willow Springs Rd
La Grange, IL 60525-2600
Mailing address
5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (798) 245-9000
Other providers in La Grange, IL
- Amber T Glavor
- Luke Gleason
- Danielle Marie Goduto
- Allison Gonzalez
- Gordon Fimreite, DC, S.C.
- Dominique Gousset
- Mallory Greenbank
- Kimberly Allison Gregoriou
- William H Gros
- Tammy Michele Gross-McCoy
All providers in La Grange, IL · Diagnostic Radiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.